Nutrition Articles by Richard Kunin, MD

Coenzyme Q10: A Miracle Vitamin

Coenzyme Q should be called vitamin Q because the amount that the body can make is insufficient for the best of health, and extra amounts of Q must be obtained from food. That makes CoQ fit the definition of vitamin: a natural, organic substance in food that is required for health and survival. However the abbreviation, CoQ, has caught on and since it is concise it will continue in use.

CoQ was discovered in 1957 by Dr. Frederick Crane at University of Wisconsin and methods of synthesis were soon developed by Dr. Karl Folkers, then a chief researcher at Merck & Co. However Merck chose not to undertake commercial production and Dr. Folkers eventually became a consultant to pharmaceutical companies in Japan where his research in diseases of muscle, such as muscular dystrophy and heart failure, earned him the Priestley medal of the American Chemical Society in 1986. However, despite hundreds of research reports on CoQ, American physicians still resist the idea that a natural vitamin can be as powerful as a pharmacological drug.

One of my patients was given the very best of conventional care for congestive heart failure at a university hospital. After 16 years of Sarcoid lung disease he had developed severe fibrosis, which caused increased resistance to blood flow in the lungs. This increased the load on the right ventricle of his heart, which eventually became depleted and weakened so that edema fluid backed up in his abdomen, liver and lower extremities. His legs were hugely swollen from the toes to the hips. Diuretics, digitalis and prednisone failed and a heart transplant was considered but ruled out due to his weakened condition. He was literally sent home to die!

However once at home he could be treated with megadoses of Coenzyme Q. A miracle! In ten days he lost over 20 pounds, about 10 quarts of fluid, the edema cleared and he was able to walk and breathe comfortably for the first time in months. Not cured entirely, of course, but well enough so that six months later he was still out of his wheel chair and able to climb the stairs to the Opera House balcony, resulting in a medical emergency when he fainted due to the acute load on his heart. He felt so well he pushed himself too far. This was the case that made a believer out of this doctor!

CoQ has a chemical name, Ubiquinone, which derives from the fact that it is ubiquitous, found in almost all plant and animal cells that use oxygen to power their chemistry. Ubiquinone is a co-enzyme, a substance that teams up with an otherwise inactive enzyme complex to make it complete—and active. The energy of oxidation in cells depends on CoQ in partnership with niacinamide (vitamin B3), riboflavin (vitamin B2), and minerals such as iron and copper to effect the movement of electrons and hydrogen protons in the power plant of cell, the mitochondrion.

Mitochondria are the specialized microscopic cell bodies that oxidize the carbohydrates and fats from food, separate off the negatively charged electrons and pump out the positively charged hydrogen protons to create a miniature battery in each cell of the body. This mechanism is literally the life force. CoQ acts as a transporter to safely carry these electrical charges from the inner membrane of the mitochondrion to the matrix where the electrons participate in the manufacture of ATP, thus converting electrical to chemical energy.

Because CoQ can donate protons, it serves as an antioxidant to prevent a leak of electrons that could oxidize and damage the cell membranes. This is all to the good unless under highly oxidative conditions, such as physical or mental stress or infection, it can be depleted. It is ironic that starvation, which lowers metabolic activity and reduces the production of peroxides and free radicals, spares CoQ which is then more available for energy. On the other hand, over-eating, especially fried foods and salad oils (except olive oil) presents the tissues with toxic free radicals, electronically unbalanced by-products that damage cell membranes and use up CoQ.

A low calorie, low fat diet promotes higher CoQ levels and a sense of energy and well-being thereby. Or one might use supplements of CoQ as an antidote to the dietary and lifestyle hazards that cause CoQ deficiency to be so common. In addition vitamin E protects against depletion of CoQ by fatty acid peroxidation. By increasing tissue levels of CoQ there is a boost in mental and physical energy and a decreased requirement for sleep, a pleasant surprise for many who try supplementing for the first time. It works!

It is possible to stimulate your body to produce more CoQ by increasing intake of certain nutrients, such as the amino acid, tyrosine, and the mineral, magnesium. CoQ is manufactured by our own cells from the amino acid, tyrosine and farnesyl, an intermediate in the production of cholesterol. Magnesium is a required catalyst for CoQ synthesis and that is one reason why many people feel more energetic after magnesium supplementation.

On the other hand, some medications can interfere with CoQ. Lovastatin, which blocks cholesterol synthesis by preventing the production of farnesyl, can induce a state of chronic fatigue. Anti-hypertensive beta-blocker medications, such as propanolal, also interfere with CoQ and the fatigue and weakened heart-beat caused by these medications can be reversed by supplemental CoQ. Doxorubicin (Adriamycin), an anti-cancer antibiotic, blocks CoQ so completely that some patients suffer heart damage—which is preventable by taking CoQ. Tetracycline antibiotics, such as doxycycline, also block CoQ and cause fatigue and weakness, which responds to CoQ supplements. Barbiturates also block CoQ and so do the common phenothiazine tranquilizers and tricyclic anti-depressants.

Pesticides (especially rotenone) and toxic chemicals, including ozone and solvents, also deplete CoQ. With so many hazards in the environment, it is more important than ever to get extra CoQ in food or in supplements. It appears that as little as 30 milligrams per day is adequate for everyday use. For significant medical symptoms, however, doses of 60 to 120 milligrams per day for at least two months may be required. It is unlikely that these megadose intakes can be obtained through food. What are the best dietary sources?

Cells that contain mitochondria for oxidation are the best souce of CoQ. The more mitochondria, the more energy production, the more CoQ. Heart is the richest food source of CoQ because it is the most active muscle in our body, contracting once a second, day and night. It contains about 6 milligrams of CoQ per 3 ounce portion. Liver contains a quarter as much and body muscle meats a fifth to a tenth as much. Spinach has about 2/3 as much as heart but portions are smaller, usually only an ounce and that cuts the actual intake to about 1.5 milligrams.

Seeds contain coenzyme Q and unrefined corn oil and rice oil actually contain 3 to 5 times more CoQ than does heart! On average a tablespoonful of unrefined salad oil contains between a half milligram and 6 milligrams. If these natural foods are eaten regularly the Co Q intake might come up to 12 or 15 mg daily. Incidentally, tobacco leaf is the champion source, containing 184 mg in a quarter pound. In fact, the Japanese companies make their CoQ from tobacco, however it is only released by means of bacterial fermentation not by smoking.

CoQ is required for cell energy. This translates into increased cell activity, greater production of cellular products, such as proteins for faster healing of wounds and hormones, for adaptation. There are impressive reports of improved blood sugar in diabetes, for instance. CoQ strengthens the immune system, conferring greater resistance to infection, not due to increased numbers of white blood cells but greater potency of the existing cells. This has obvious applications in AIDS.

Red blood cells also thrive with CoQ and some cases of anemia respond very well. Skin cells are responsive and psoriasis, in particular, may improve. Bleeding gums due to periodontal disease often clear up after a time on CoQ—even when the blood level is normal. Nerve tissue is sensitive to CoQ and it is a useful treatment of retinal diseases, including optic atrophy. It is also beneficial in peripheral nerve disease.

But it is in the treatment of heart conditions that CoQ is most impressive, especially in patients with cardiomyopathy and congestive heart failure. In one major study 75 percent of those on CoQ survived 6 years while 75 percent not on CoQ died in 3 years or less. High blood pressure often improves on CoQ and mitral valve prolapse is very responsive. Even in normal conditions, large doses of CoQ increase muscle strength and cardiac output: this is especially noticeable amongst athletes and long distance runners, where performance is more obvious and measurable.

Tissue levels of CoQ decline as much as 80% in old age and this single fact appears to explain some of the increased risk of heart failure, immune dysfunction, delayed healing and general weakening of energy and strength that are stereotypical of growing old. By simply taking supplements of CoQ, this age-related drop in vitality can be reversed to an amazing extent.

Finally, in the research laboratory, treatment with CoQ extends the life span of mice by about 50 percent. Compare this to the low calorie life extension diet, which yields a 30 percent increase in lifespan in mice. CoQ is certainly more pleasant than a life of semi-starvation. If this is verified for humans, vitamin Q should become a household word. It should already be prized as a powerful treatment in medical practice. For those of us in orthomolecular medicine it is.

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